Main Pulmonary Artery Aneurysm

Abstract

Pulmonary artery aneurysm is a rare lesion of the thoracic cavity. Different etiologies have been reviewed, but idiopathic lesions without other symptoms are seldom reported. Usually, surgical interventions are suggested, but the long-term outcomes are not well established. Here, we report a 24-year-old man with main pulmonary artery aneurysm who successfully underwent aneurysmectomy and polytetrafluoroethylene vascular graft replacement. The postoperative course was uneventful, and the following image study revealed normal size of the great vessels.

Aneurysms of the Pulmonary Artery

“…[34][35][36] Greene and Baldwin 37 have defined 4 pathological criteria for an idiopathic PAA: simple dilatation of the pulmonary trunk with or without involvement of the rest of the arterial tree, the absence of intracardiac or extracardiac shunts, the absence of chronic cardiac or pulmonary disease, and the absence of arterial disease such as syphilis or more than minimal atheromatosis or arteriosclerosis of the pulmonary vascular tree.…”

“…9,20,34 Clinical symptoms include dyspnea, chest pain, hoarseness, palpitation, and syncopal episodes. 6,14,20,21,[34][35][36] Bronchus compression by a large PAA may be responsible for cyanosis, cough, and increasing dyspnea, pneumonia, fever, and bronchiectasis. 20,21,28,34,35,39 In addition, patients with PAA have a high incidence of pulmonary emboli.…”

Extreme pulmonary artery aneurysm with thrombosis

“…The aneurysms in the main pulmonary artery and its two branches are classified as PAA [2]. In autopsy studies the PAA frequency was found to be 1:14000 [1].…”

“…Veldtman et al suggested that in low pressure aneurysms, the timing for surgery depends on the size and function of the right ventricle (related to pulmonary stenosis or insufficiency) rather than the size of the aneurysm [1]. Considering the size of the aneurysm and the possibility of anticoagulation, the patient was referred to pneumonology, rheumatology and cardiovascular surgery for further evaluation and treatment.…”

“…The main pulmonary artery aneurysm is considered a rare entity [1]. Pressure on bronchial three, pulmonary artery dissection, and rupture and thrombus formation are the potential complications of pulmonary artery aneurysms [2].…”